Showing papers by "University of Nigeria, Nsukka published in 2015"

Health care financing in Nigeria: Implications for achieving universal health coverage

Abstract: The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms. The difference in the proportionate contribution from these stated sources determine the extent to which such health sector will go in achieving successful health care financing system. Unfortunately, in Nigeria, achieving the correct blend of these sources remains a challenge. This review draws on relevant literature to provide an overview and the state of health care financing in Nigeria, including policies in place to enhance healthcare financing. We searched PubMed, Medline, The Cochrane Library, Popline, Science Direct and WHO Library Database with search terms that included, but were not restricted to health care financing Nigeria, public health financing, financing health and financing policies. Further publications were identified from references cited in relevant articles and reports. We reviewed only papers published in English. No date restrictions were placed on searches. It notes that health care in Nigeria is financed through different sources including but not limited to tax revenue, out-of-pocket payments (OOPs), donor funding, and health insurance (social and community). In the face of achieving UHC, achieving successful health care financing system continues to be a challenge in Nigeria and concludes that to achieve universal coverage using health financing as the strategy, there is a dire need to review the system of financing health and ensure that resources are used more efficiently while at the same time removing financial barriers to access by shifting focus from OOPs to other hidden resources. There is also need to give presidential assent to the national health bill and its prompt implementation when signed into law.

Eco-friendly asbestos free brake-pad: Using banana peels

Abstract: The use of asbestos fibre is being avoided due to its carcinogenic nature that might cause health risks. A new brake pad produced using banana peel waste to replace asbestos and Phenolic resin (phenol formaldehyde), as a binder was investigated. The resin was varying from 5 to 30 wt% with an interval of 5 wt%. Morphology, physical, mechanical and wear properties of the brake pad were studied. The results show that compressive strength, hardness and specific gravity of the produced samples were seen to be increasing with an increase in wt% of resin addition, while oil soak, water soak, wear rate and percentage charred decreased as the wt% of resin increased. Overall samples, containing 25 wt% in uncarbonized banana peels (BUNCp) and 30 wt% in carbonized (BCp) gave better properties. The result of this research indicates that banana peel particles can be effectively used as a replacement for asbestos in brake pad manufacture.

Effects of eggshell on the microstructures and properties of Al-Cu-Mg/eggshell particulate composites

Abstract: The effects of eggshell particles (ES) on the microstructures and properties of Al–Cu–Mg/ES particulate composites have been studied. A total of 2–12 wt.% ES particles were added. The microstructures of the Al–Cu–Mg/eggshell particulate composites produced were examined by a scanning electron microscope with energy dispersive spectrometer (SEM/EDS). The physical and mechanical properties measured included: density, tensile strength, hardness values and impact energy. The results revealed that the tensile strength increased by 8.16% at 12 wt.% uncarbonized ES and 14.28% at 12 wt.% carbonized ES, the hardness values increased by 10.01% at 12 wt.% uncarbonized ES and 25.4% at 12 wt.% carbonized ES with decrease in the density by 6.50% at 12 wt.% uncarbonized ES and 7.4% at 12 wt.% carbonized ES. The impact energy decreased by 23.5% at 12 wt.% uncarbonized ES and 24.67% at 12 wt.% carbonized ES particles, respectively. These increases in strength and hardness values are attributed to the distribution of hard phases of the ES particles in the ductile Al–Cu–Mg alloy matrix. These results showed that using the carbonized eggshell as reinforcement in the Al–Cu–Mg alloy gives better physical and mechanical properties as compared to uncarbonized ES particles. Hence addition of ES particles upto 12 wt.% can be used as a low cost reinforcement for the production of metal matrix composites for engineering applications.

The 2014 alma long baseline campaign: an overview*

Abstract: A major goal of the Atacama Large Millimeter/submillimeter Array (ALMA) is to make accurate images with resolutions of tens of milliarcseconds, which at submillimeter (submm) wavelengths requires baselines up to ~15 km. To develop and test this capability, a Long Baseline Campaign (LBC) was carried out from 2014 September to late November, culminating in end-to-end observations, calibrations, and imaging of selected Science Verification (SV) targets. This paper presents an overview of the campaign and its main results, including an investigation of the short-term coherence properties and systematic phase errors over the long baselines at the ALMA site, a summary of the SV targets and observations, and recommendations for science observing strategies at long baselines. Deep ALMA images of the quasar 3C 138 at 97 and 241 GHz are also compared to VLA 43 GHz results, demonstrating an agreement at a level of a few percent. As a result of the extensive program of LBC testing, the highly successful SV imaging at long baselines achieved angular resolutions as fine as 19 mas at ~350 GHz. Observing with ALMA on baselines of up to 15 km is now possible, and opens up new parameter space for submm astronomy.

Agricultural adaptation strategies to climate change impacts in Africa: a review.

Abstract: Climate change is expected to intensify existing problems and create new combinations of risks, particularly in Africa. The situation is made worst due to factor such as widespread poverty, over dependence on rain fed agriculture, inequitable land distribution, limited access to capital and technology, inadequate public infrastructure, such as roads, long term weather forecasts and inadequate research and extension. By lessening the severity of key damages to the agricultural sector, adaptation is the key defensive measure. Adaptation to climate change involves changes in agricultural management practices in response to changes in climate conditions. This paper reviews agricultural adaptation strategies employed by farmers in various countries in Africa in cushioning the effects of climate change. The common agricultural adaptation strategies used by farmers were the use of drought resistant varieties of crops, crop diversification, changes in cropping pattern and calendar of planting, conserving soil moisture through appropriate tillage methods, improving irrigation efficiency, and afforestation and agro-forestry. The paper concluded that improving and strengthening human capital through education, outreach programmes, extension services at all levels will improve capacity to adapt to climate change impact. DOI: http://dx.doi.org/10.3329/bjar.v39i3.21984 Bangladesh J. Agril. Res. 39(3): 407-418, September 2014

Synthesis, characterization and gas-sensing properties of SILAR deposited ZnO-CdO nano-composite thin film

Abstract: The deposition of ZnO-CdO thin films are carried out using successive ionic layer adsorption and reaction (SILAR) method at room temperature. The deposited ZnO-CdO thin films have been characterized using FT-Raman spectroscopy, scanning electron microscopy, UV-vis spectrophotometer, two point probe resistivity method, and contact angle mode. Raman spectroscopy show various peaks from the as deposited films which disappeared after annealing. The SEM reveals the morphology of the films nanosized smooth interlocked sheets all over the surface. The bandgap value of 3.8 eV is observed for as deposited but decreased to 2.9 eV after annealing. Activation energies of 0.43 and 0.11 eV are estimated for the as deposited film and annealed film, respectively. The Gas response of the ZnO-CdO composite film shows maximum (about 50%) at 623 K upon exposure to 780 ppm of LPG.

Thermodynamic controls of the Atlantic Niño

Abstract: Prevailing theories on the equatorial Atlantic Nino are based on the dynamical interaction between atmosphere and ocean. However, dynamical coupled ocean-atmosphere models poorly simulate and predict equatorial Atlantic climate variability. Here we use multi-model numerical experiments to show that thermodynamic feedbacks excited by stochastic atmospheric perturbations can generate Atlantic Nino s.d. of ∼0.28±0.07 K, explaining ∼68±23% of the observed interannual variability. Thus, in state-of-the-art coupled models, Atlantic Nino variability strongly depends on the thermodynamic component (R(2)=0.92). Coupled dynamics acts to improve the characteristic Nino-like spatial structure but not necessarily the variance. Perturbations of the equatorial Atlantic trade winds (∼±1.53 m s(-1)) can drive changes in surface latent heat flux (∼±14.35 W m(-2)) and thus in surface temperature consistent with a first-order autoregressive process. By challenging the dynamical paradigm of equatorial Atlantic variability, our findings suggest that the current theories on its modelling and predictability must be revised.

Conflicts about water in Lake Chad: Are environmental, vulnerability and security issues linked?

Abstract: This article builds on the growing literature that explores the relationships between environmental change and non-traditional security, defined as non-military threats that challenge the survival ...

Knowledge of danger signs in newborns and health seeking practices of mothers and care givers in Enugu state, South-East Nigeria

Abstract: According to UNICEF, 40% of all under-5 deaths occur within the first month of life and half of these within the first few days of life. Many of these deaths are related to late recognition of neonatal illness, delays in decision to seek care at household level and subsequent late intervention at healthcare facilities. Knowledge of mothers about the danger signs in newborn is imperative to reduce these delays and preventable deaths. This study aimed to assess the perception of mothers and/or care givers of danger signs in newborns and their knowledge of the WHO recognized danger. A secondary aim was to explore the socio-demographic factors of mothers that influence knowledge of the WHO recognized danger signs and the health seeking behaviors of these mothers and/or care-givers. This was a community based descriptive and analytical study which used a multistage sampling technique to select 376 mothers and/or care-givers from four communities in 4 of the 17 Local Government Areas (LGA) of Enugu State. Logistic regression and chi-square was used in testing associations between variables. Knowledge of more than three of the nine WHO recognized danger sign was poor (0.0-30.3%). Majority of the mothers had knowledge of one (i.e. fever) WHO recognized danger sign (95.2%). Knowledge of the WHO signs was not significantly associated with maternal socio-demographic variables considered in this study. Healthcare seeking behaviour was significantly determined by knowledge of at least one WHO recognized danger sign (OR 4.6 CI 1.1-18.7, P = 0.032). Cough, diarrhea and the excessive crying were the most perceived and experienced non-WHO recognized dangers signs among respondents. There is urgent need to strengthen the teaching and training of expectant mothers across all maternal socio-demographic variables on these danger signs and the most appropriate measures to take when they occur.

The geotechnical characteristics of landslides on the sedimentary and metamorphic terrains of South-East Nigeria, West Africa

Abstract: Landslides in Nigeria occur in various forms and vary in mode, scale and frequency. The variations appear to be significantly controlled by geologic setting, hence the need to study in detail the distinctive features that differentiate landslides in sedimentary environments from those on metamorphic localities. The aim is to understand the actual features impacted on the landslides by geology, from which future predictions of occurrence and identification of instability could be based. The recognition of features that are characteristic of certain geologic setting may be a major step in early warning development in Nigeria. To achieve the objectives detailed mapping of the study area was carried out using topographic maps, aerial photographs and multiple field surveys. The landslides on the sedimentary terrain were mainly shallow, low-volume movements, material slumps and short runout slides some of which activated on slopes that followed the dip of strata, along wavy shear surfaces controlled by impermeable bedding planes. Runoff-triggered movements caused by erosion of channel bed and banks and failures caused by sediment bulking of runoff with material eroded from headwater slopes are also common on the sedimentary terrain. In comparison, the landslides on the metamorphic terrain were complex translational and rotational movements and mudslides on steep slopes sometimes involving a combination of slide and flow with curved headscarps and slickensided shear surfaces. The looseness of slope materials and their relatively low strength parameters account for the dominance of landslides on the sedimentary zone.

Improving maternal nutrition for better pregnancy outcomes.

Abstract: Much has been learned during the past several decades about the role of maternal nutrition in the outcome of pregnancy. While the bulk of the data is derived from animal models, human observations are gradually accumulating. There is need to improve maternal nutrition because of the high neonatal mortality rate especially in developing countries. The author used a conceptual framework which took both primary and secondary factors into account when interpreting study findings. Nutrition plays a vital role in reducing some of the health risks associated with pregnancy such as risk of fetal and infant mortality, intra-uterine growth retardation, low birth weight and premature births, decreased birth defects, cretinism, poor brain development and risk of infection. Adequate nutrition is essential for a woman throughout her life cycle to ensure proper development and prepare the reproductive life of the woman. Pregnant women require varied diets and increased nutrient intake to cope with the extra needs during pregnancy. Use of dietary supplements and fortified foods should be encouraged for pregnant women to ensure adequate supply of nutrients for both mother and foetus. The author concludes that nutrition education should be a core component of Mother and Child Health Clinics and every opportunity should be utilised to give nutrition education on appropriate diets for pregnant women.

Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region.

Abstract: Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations.

Steroid-sensitive nephrotic syndrome in children: triggers of relapse and evolving hypotheses on pathogenesis.

Abstract: Nephrotic syndrome remains the most common manifestation of glomerular disease in childhood. Minimal change nephropathy is the most common cause of the syndrome in children. Despite its initial high response rate to corticosteroids and its favorable prognosis, relapses are common leading to increased morbidity and cost of treatment. This review seeks to appraise the common triggers of relapse and to highlight the evolving hypotheses about the pathogenesis of the syndrome. Literature search was conducted through PubMed, Google web search and Cochrane Database of Systematic reviews using relevant search terms. Acute respiratory infections and urinary tract infections are the most frequent infectious triggers of relapse. Targeted interventions like initiating corticosteroid or its dose-adjustment during episodes of acute respiratory infection and zinc supplementation are reportedly effective in reducing relapse rates. Hypotheses on pathogenesis of the syndrome have evolved from the concepts of ‘immune dysregulation’, ‘increased glomerular permeability’ to ‘podocytopathy’. Although development of drugs which can regulate the pathways for podocyte injury offers future hope for effective and targeted treatment, the relapse-specific interventions currently contribute to significant reduction in disease morbidity.

Prevalence of class 1 and 2 integrons in multi-drug resistant Escherichia coli isolated from aquaculture water in Chaharmahal Va Bakhtiari province, Iran

Abstract: Background: Integrons play important role in the spread and maintenance of antimicrobial resistance among strains of Escherichia coli (E. coli) and other species of Enterobacteriaceae. This study investigated the prevalence of class 1 and 2 integrons among E. coli strains isolated from aquaculture water of fish fields in Iran. Methods: One hundred and fifty water samples from different geographical regions in Chaharmahal Va Bakhtiari province were examined over a 2 months period. Isolation was through culture and biochemical tests. Integrons were identified through polymerase chain reaction (PCR) using oligonucleotide primers specific for class 1 and 2 integrons. Antimicrobial susceptibility testing was carried out using disc diffusion methods. Results: Eighteen percent of the water samples were positive for E. coli. All the strains were multi-drug resistant; 100% to ciprofloxacin, chloramphenicol, gentamycin, ampicillin and tetracycline and least resistant to imipenem (7.2%). Ten (50%) of the most resistant strains were positive for class 1 (40%) and class 2 (10%). Conclusions: Escherichia coli in aquaculture in Iran carried integrons class 1 and 2 which could be of public health concern since they could play a role in the spread and maintenance of antimicrobial resistance among bacterial population in the region and should be constantly monitored.

Spatial Analysis of Vulnerability to Flooding in Port Harcourt Metropolis, Nigeria

Abstract: This study analyzed the vulnerability to flooding in Port Harcourt metropolis, Nigeria, by creating vulnerability indices and comparing these indices across the 13 zones that make up Port Harcourt metropolis. The integrated vulnerability assessment approach using indicators was adopted. The indicators were grouped into adaptive capacity, sensitivity, and exposure based on the Intergovernmental Panel on Climate Change definition of vulnerability. The data on these indicators were obtained from fieldwork, questionnaire, and map measurements. Principal component analysis was performed to obtain the first component scores which were used to weight the variables before calculating the vulnerability indices of the 13 zones. The vulnerability indices results show that Mgbuosimiri (Zone K) is relatively the most vulnerable, whereas the least vulnerable is Eligbolo (Zone D). Cluster analysis was used to group the different vulnerability indices to produce a vulnerability map showing the spatial pattern of the different flood vulnerability levels (i.e., very high, high, low, and very low vulnerability levels). The spatial pattern of the vulnerability levels increases toward the north west, south west, south, and north east, and decreases toward the central of Port Harcourt. However, the vulnerability map can be used for the reduction of damage potential by integrating its outputs into spatial planning and emergency planning.

Status of municipal solid waste generation and disposal in Nigeria

Abstract: Purpose – This paper examined the current status of municipal solid waste management across Nigeria. The core aspects covered are generation, characterization, collection, scavenging, open dumping, disposal and environmental implications of poor solid waste management. The purpose of this paper is to present a comprehensive overview of the current state of municipal solid waste management in Nigeria. Design/methodology/approach – This study was executed by a combination of an extensive literature search and field study. Solid waste generation rates for 31 Nigerian cities were obtained from literature. In addition, characteristics of municipal solid waste from 26 Nigerian cities were also obtained from literature. Other aspects such as characterization of solid waste obtained from final dumpsite and heavy metals accumulation in solid waste dumpsites were undertaken first hand. Findings – Solid waste generation rate was found to vary from 0.13 kg/capita/day in Ogbomosho to 0.71 kg/capita/day in Ado-Ekiti. F...

Evaluation of Genome Wide Association Study Associated Type 2 Diabetes Susceptibility Loci in Sub Saharan Africans.

Abstract: Genome wide association studies (GWAS) for type 2 diabetes (T2D) undertaken in European and Asian ancestry populations have yielded dozens of robustly associated loci. However, the genomics of T2D remains largely understudied in sub-Saharan Africa (SSA), where rates of T2D are increasing dramatically and where the environmental background is quite different than in these previous studies. Here, we evaluate 106 reported T2D GWAS loci in continental Africans. We tested each of these SNPs, and SNPs in linkage disequilibrium (LD) with these index SNPs, for an association with T2D in order to assess transferability and to fine map the loci leveraging the generally reduced LD of African genomes. The study included 1775 unrelated Africans (1035 T2D cases, 740 controls; mean age 54 years; 59% female) enrolled in Nigeria, Ghana, and Kenya as part of the Africa America Diabetes Mellitus (AADM) study. All samples were genotyped on the Affymetrix Axiom PanAFR SNP array. Forty-one of the tested loci showed transferability to this African sample (p < 0.05, same direction of effect), 11 at the exact reported SNP and 30 others at SNPs in LD with the reported SNP (after adjustment for the number of tested SNPs). TCF7L2 SNP rs7903146 was the most significant locus in this study (p = 1.61 × 10(-8)). Most of the loci that showed transferability were successfully fine-mapped, i.e., localized to smaller haplotypes than in the original reports. The findings indicate that the genetic architecture of T2D in SSA is characterized by several risk loci shared with non-African ancestral populations and that data from African populations may facilitate fine mapping of risk loci. The study provides an important resource for meta-analysis of African ancestry populations and transferability of novel loci.

Alienation and Psychological Wellbeing: Moderation by Resilience

Abstract: This study adopted the radical perspective of perceived alienation in interpersonal, political and socio-economic domains of life and examined their relationships to psychological wellbeing. The moderator role of resilience on the relationship of the three facets of alienation and psychological wellbeing was also investigated. Psychological wellbeing was conceptualized as self-report of psychological distress. Participants were 337 undergraduate students (164 males, 173 females; Mage = 23.42, SD = 3.70) who are indigenous young adults of the oil-rich Niger Delta region of Nigeria. Pearson’s correlations and multiple regression analysis were used to analyse the data. Results showed that interpersonal alienation, political alienation and socio-economic alienation were positively associated with psychological distress while resilience was negatively related to psychological distress. Psychological distress was also predicted by alienation and resilience. Resilience neither moderated the relationship of interpersonal alienation and psychological distress nor political alienation and psychological distress but the relationship between socio-economic alienation and psychological distress was moderated by resilience. It was concluded that initiation of resilience building programmes as a form of cognitive-behavioural and existential interventions may buffer the negative relationship of alienation to psychological distress.

The mediating role of perceived employability in the relationship between core self-evaluations and job search behaviour

Abstract: Purpose – The purpose of this paper is to examine the mediating role of perceived employability in the relationship between core self-evaluations (CSEs) and job search behaviour (preparatory and active job search). Design/methodology/approach – A cross-sectional survey data were obtained among a sample of 254 employed and unemployed graduate students from a university in Southeast Nigeria. Findings – Results of the hierarchical multiple regression show that CSEs was significantly and positively associated with only preparatory job search behaviour but not active job search behaviour. CSEs was positively associated with perceived employability. Perceived employability was positively associated with the preparatory job search but not active job search. Perceived employability also mediated the relationship between CSEs and preparatory job search but failed to mediate the relationship between CSEs and active job search. Research limitations/implications – The study makes important contribution to the literat...

Evaluation of aquifer protective capacity of overburden unit and soil corrosivity in Makurdi, Benue state, Nigeria, using electrical resistivity method

Abstract: This paper presents result of 30 vertical electrical soundings carried out in Makurdi, Benue state capital, north–central Nigeria to evaluate aquifer protective capacity and soil corrosivity of overburden units in the study area. This was done using the Schlumberger electrode array to obtain the data and was modelled using computer iteration (Winresist software). The field data gives a resolution with 3–4 geoelectric layers and the observed frequencies in curve types include: 30% of KQ, 16.67% of QH, 6.67% of AA and K, 3.33% of HA, Q and A, 10% of H, KH and HK. Using the longitudinal unit conductance (S), the protective capacities of the study area were classified as 36.67% weak, 10% poor, 40% moderate, and 13.33% as good. The corrosivity ratings of the study area show that 10% is strongly corrosive, 23% moderately corrosive, 37% slightly corrosive, and 30% noncorrosive The results reasonably provide information on areas where industries can be sited and iron pipes can be laid in order to safeguard the hydrological setting for resident’s safety in the study area. Regions with moderate/good protective capacity are good sites for locating boreholes.

A Novel Schiff Base of 3-acetyl-4-hydroxy-6-methyl-(2H)pyran-2-one and 2,2'-(ethylenedioxy)diethylamine as Potential Corrosion Inhibitor for Mild Steel in Acidic Medium

Abstract: The corrosion inhibition activity of a newly synthesized Schiff base (SB) from 3-acetyl-4-hydroxy-6-methyl-(2H)-pyran-2-one and 2,2'-(ethylenedioxy)diethylamine was investigated on the corrosion of mild steel in 1 M HCl solution using potentiodynamic polarization and electrochemical impedance spectroscopic techniques. Ultraviolet-visible (UV-vis) and Raman spectroscopic techniques were used to study the chemical interactions between SB and mild steel surface. SB was found to be a relatively good inhibitor of mild steel corrosion in 1 M HCl. The inhibition efficiency increases with increase in concentration of SB. The inhibition activity of SB was ascribed to its adsorption onto mild steel surface, through physisorption and chemisorption, and described by the Langmuir adsorption model. Quantum chemical calculations indicated the presence of atomic sites with potential nucleophilic and electrophilic characteristics with which SB can establish electronic interactions with the charged mild steel surface.

Anti-trypanosomal activity of nigerian plants and their constituents.

Abstract: African trypanosomiasis is a vector-borne parasitic disease causing serious risks to the lives of about 60 million people and 48 million cattle globally. Nigerian medicinal plants are known to contain a large variety of chemical structures and some of the plant extracts have been screened for antitrypanosomal activity, in the search for potential new drugs against the illness. We surveyed the literatures on plants and plant-derived products with antitrypanosomal activity from Nigerian flora published from 1990 to 2014. About 90 plants were identified, with 54 compounds as potential active agents and presented by plant families in alphabetical order. This review indicates that the Nigerian flora may be suitable as a starting point in searching for new and more efficient trypanocidal molecules.

Functional analysis of drug resistance-associated mutations in the Trypanosoma brucei adenosine transporter 1 (TbAT1) and the proposal of a structural model for the protein.

Abstract: The Trypanosoma brucei aminopurine transporter P2/TbAT1 has long been implicated in the transport of, and resistance to, the diamidine and melaminophenyl arsenical classes of drugs that form the backbone of the pharmacopoeia against African trypanosomiasis. Genetic alterations including deletions and single nucleotide polymorphisms (SNPs) have been observed in numerous strains and clinical isolates. Here, we systematically investigate each reported mutation and assess their effects on transporter function after expression in a tbat1(-/-) T. brucei line. Out of a set of six reported SNPs from a reported 'resistance allele', none significantly impaired sensitivity to pentamidine, diminazene or melarsoprol, relative to the TbAT1-WT allele, although several combinations, and the deletion of the codon for residue F316, resulted in highly significant impairment. These combinations of SNPs, and ΔF316, also strongly impaired the uptake of [(3)H]-adenosine and [(3)H]-diminazene, identical to the tbat1(-/-) control. The TbAT1 protein model predicted that residues F19, D140 and F316 interact with the substrate of the transporter. Mutation of D140 to alanine resulted in an inactive transporter, whereas the mutation F19A produced a transporter with a slightly increased affinity for [(3)H]-diminazene but reduced the uptake rate. The results presented here validate earlier hypotheses of drug binding motifs for TbAT1.

Role and use of evidence in policymaking: an analysis of case studies from the health sector in Nigeria

Abstract: Health policymaking is a complex process and analysing the role of evidence is still an evolving area in many low- and middle-income countries. Where evidence is used, it is greatly affected by cognitive and institutional features of the policy process. This paper examines the role of different types of evidence in health policy development in Nigeria. The role of evidence was compared between three case studies representing different health policies, namely the (1) integrated maternal neonatal and child health strategy (IMNCH); (2) oral health (OH) policy; and (3) human resource for health (HRH) policy. The data was collected using document reviews and 31 in-depth interviews with key policy actors. Framework Approach was used to analyse the data, aided by NVivo 10 software. Most respondents perceived evidence to be factual and concrete to support a decision. Evidence was used more if it was perceived to be context-specific, accessible and timely. Low-cost high-impact evidence, such as the Lancet series, was reported to have been used in drafting the IMNCH policy. In the OH and HRH policies, informal evidence such as experts’ experiences and opinions, were reported to have been useful in the policy drafting stage. Both formal and informal evidence were mentioned in the HRH and OH policies, while the development of the IMNCH was revealed to have been informed mainly by more formal evidence. Overall, respondents suggested that formal evidence, such as survey reports and research publications, were most useful in the agenda-setting stage to identify the need for the policy and thus initiating the policy development process. International and local evidence were used to establish the need for a policy and develop policy, and less to develop policy implementation options. Recognition of the value of different evidence types, combined with structures for generating and using evidence, are likely to enhance evidence-informed health policy development in Nigeria and other similar contexts.